Belmarsh

Response
I acknowledge the Board’s concern for people in prison who are mentally unwell and waiting for a transfer to a secure hospital, and the distress that this can result in. The unprecedented demand across communities and admission difficulties caused by the Covid-19 pandemic has exacerbated the challenges of securing suitable beds on appropriate admission wards. The complex needs of some prisoners continues to present a challenge and prolonged segregation of prisoners with severe mental ill health or personality disorder remains a serious concern. For reasons of medical confidentiality I am unable to go into detail about the specific circumstances of the individual who was held for several months in the segregation unit, however, I can confirm that he has following a comprehensive referral and assessment process now been transferred to a medium secure placement. I hope to reassure the Board that NHS England and NHS Improvement (NHSE/I) Health and Justice National Team have developed a system portal to report all transfers to mental health hospitals, so that referral rates, response times, timeliness of assessments, and admission timescales can be closely monitored. In the London region, a monthly prison mental health transfer and remission meeting has been established led by NHSE/I. Risks are identified through the meeting around extended waiting times beyond current guidance timescales; cases are proactively followed up with mental health Provider Collaboratives to progress patient transfers. Where barriers to timely transfers remain, arrangements can be made to source privately funded beds where NHS beds are not available. In addition, Oxleas NHS Foundation Trust has a dedicated Transfer and Remissions Co-ordinator in post to proactively manage and oversee the cohort of patients requiring a secure hospital placement. Regarding unpredictable behaviour issues, the risk to these individuals and others is managed through multi-disciplinary meetings and the intended decisions are focussed based around the best care for the individual and considering of others living and working on the unit.

Response
Turning to the Board’s concerns about those on remand for a prolonged period, my officials in the Ministry of Justice have taken steps to address the delays in the court system to help reduce the length of time people are being held awaiting trial and a decision by the court. I am pleased to mention that there was no limit on Crown Court sitting times this year; 70 courtrooms were reconfigured to enable large trials to be heard and 32 Nightingale courtrooms have been extended until April 2022. In London, we are achieving close to pre-Covid courtroom capacity, aided significantly by the installation of Perspex screens to support safe distancing and the opening of 14 additional Nightingale courtrooms. Work is progressing to increase dock capacity and where it is safe to do so, and in line with the UK Health Security Agency guidance, to reintroduce cell sharing at a number of sites, to increase provision for multiple defendants. Furthermore, since the launch of the unified Probation Service on 26 June 2021, Probation Pre-Release Teams are resourced to provide services not available via the Commissioned Rehabilitative Service including tenancy sustainment. HMP Belmarsh will establish with partners what services remain available and communicate this to the men in their care. Probation Pre-Release Teams will provide immediate resettlement needs and support for the unconvicted population. The minimum provision will include assessment under Basic Custody Screening Tool 2 (BCST2) and undertaking specialist immediate needs work around accommodation and debt. The teams will also provide a pre-release service for people in prison out of area. A resettlement pack is being developed to include sources of support and advice on accommodation. HM Prison and Probation Service (HMPPS) is currently exploring what additional accommodation and rehabilitative support could be provided to the unconvicted population.

Response
As the Board are aware, the operational capacity at HMP Belmarsh has been reduced, largely as a result of a decision to remove the practice of triple cell occupancy. There are currently no plans to reduce the staffing resources. The target staffing figures significantly increased in 2021 to provide the prison with greater capability and capacity in the areas of counter terrorism work and supplying court escorts for Category A prisoners. Resourcing requirements are frequently reviewed as staff seek new ways of working, implement post Covid-19 regime designs, use of IT solutions, and more efficient delivery models. Therefore, the funded target staffing levels at HMP Belmarsh is likely to change in the future, though as has been the case in 2021, it is possible that any changes made may increase the staffing resource levels. There are currently no plans to reintroduce the practice of locating three prisoners into cells. The risks and issues associated with the use of locating three men into cells at HMP Belmarsh have been very clearly reviewed with the HMPPS Capacity Management Team. The use of triple cells would only be an option considered in very exceptional circumstances but cannot be categorically ruled out.

Response
I acknowledge the Board’s concern for people in prison who are mentally unwell and waiting for a transfer to a secure hospital, and the distress that this can result in. The unprecedented demand across communities and admission difficulties caused by the Covid-19 pandemic has exacerbated the challenges of securing suitable beds on appropriate admission wards. The complex needs of some prisoners continues to present a challenge and prolonged segregation of prisoners with severe mental ill health or personality disorder remains a serious concern. For reasons of medical confidentiality I am unable to go into detail about the specific circumstances of the individual who was held for several months in the segregation unit, however, I can confirm that he has following a comprehensive referral and assessment process now been transferred to a medium secure placement. I hope to reassure the Board that NHS England and NHS Improvement (NHSE/I) Health and Justice National Team have developed a system portal to report all transfers to mental health hospitals, so that referral rates, response times, timeliness of assessments, and admission timescales can be closely monitored. In the London region, a monthly prison mental health transfer and remission meeting has been established led by NHSE/I. Risks are identified through the meeting around extended waiting times beyond current guidance timescales; cases are proactively followed up with mental health Provider Collaboratives to progress patient transfers. Where barriers to timely transfers remain, arrangements can be made to source privately funded beds where NHS beds are not available. In addition, Oxleas NHS Foundation Trust has a dedicated Transfer and Remissions Co-ordinator in post to proactively manage and oversee the cohort of patients requiring a secure hospital placement. Regarding unpredictable behaviour issues, the risk to these individuals and others is managed through multi-disciplinary meetings and the intended decisions are focussed based around the best care for the individual and considering of others living and working on the unit.

Response
Following a pause in the development of the new Prisoners’ Property policy framework due to Covid-19, the meeting with IMB representatives took place in August 2020. The feedback received was considered alongside the comments received from other stakeholders, and from subsequent operational engagement. HMPPS has now circulated the draft framework with internal and external stakeholders, including the IMB Secretariat and the IMB representatives previously consulted, and the large number of comments received are being considered. As a result, the framework is expected to be published early next year. The framework will provide greater direction and standardisation on a national basis and has been designed with procedural justice at its core. It strengthens guidance on known problem areas such as volumetric control and seeks to ensure prisoners’ property is managed efficiently, effectively, consistently and with care and respect. While digital improvements to property processes are being explored, the nature of this work means that any digital changes are likely to be implemented longer-term and at this stage will not be part of the framework. However, property identification numbers will now be entered on the digital platform rather than be recorded by hand on the paper Person Escort Record. This will enable better tracking of property, should it be lost in transit.

Response
Locally, during the pandemic the handing in of property was restricted, all prisoners were notified of changes in the process. As the Board have highlighted, the induction package was not multilingual at the time of the report, this is currently under a full review and improvements have been put in place. The Governor will provide more detail.